Provider Demographics
NPI:1598790701
Name:AHN, JOHN H (DO)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:H
Last Name:AHN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:3001 EXECUTIVE DR STE 130
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33762-5323
Mailing Address - Country:US
Mailing Address - Phone:727-347-0005
Mailing Address - Fax:727-541-6558
Practice Address - Street 1:1840 MEASE DRIVE
Practice Address - Street 2:SUITE 305
Practice Address - City:SAFETY HARBOR
Practice Address - State:FL
Practice Address - Zip Code:34695
Practice Address - Country:US
Practice Address - Phone:727-796-4166
Practice Address - Fax:727-669-5849
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2021-05-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLOS7005207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
281931OtherAVMED
5676415OtherAETNA
57158OtherBCBS
1136014OtherFIRST HEALTH
4775800OtherCIGNA
FL300384100Medicaid
281931OtherAVMED
FL300384100Medicaid